O021 INTERVENTIONS TO REDUCE AND PREVENT OBESITY IN PRE-CONCEPTUAL AND PREGNANT WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS

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Background: The increasing prevalence of obesity in pregnant women is associated with adverse maternal and neonatal outcomes, and increased costs to healthcare, the economy and broader society. Objectives: To assess the efficacy of behavioural interventions for managing gestational weight gain (GWG) in the preconceptual and pregnancy period in overweight, obese and morbidly obese women. Search Methods: A search was performed for published studies in the English language, from date? 2000–31 December 2012 in five electronic databases; PubMed, Scopus, Cochrane Library, CINAHL and PsycINFO. Selection criteria: Studies were included if they compared the efficacy or effectiveness of a particular behavioural intervention in pregnant or pre-conceptual women with standard maternity care. Studies that included women with comorbid conditions such as diabetes mellitus and polycystic ovarian syndrome were excluded to help isolate the effect of the intervention. Results: Fifteen studies involving 3,426 participants were included. One study (n = 692) focused on the pre-conceptual period and the remaining 14 (n = 2,734) in the pregnancy period. Pooled mean difference for GWG indicated a lower GWG in the intervention groups when compared to standard maternity care groups (n = 1771, mean difference (MD) 21.66 kg, 95% CI 23.12 to 20.21 kg). With respect to the types of participants, considerable heterogeneity between studies was shown in the obese subgroup [Tau = 15.61; Chi = 40.80, df = 3 (P,0.00001); I = 93%]. Conclusions: Behavioural interventions in pregnancy may be effective in reducing GWG in obese women without comorbid conditions, but not overweight or morbidly obese women. Behavioural interventions had no effect on postpartum weight loss or retention, gestation week of delivery and infant birth weight in overweight, obese and morbidly obese women. Citation: Agha M, Agha RA, Sandell J (2014) Interventions to Reduce and Prevent Obesity in Pre-Conceptual and Pregnant Women: A Systematic Review and Meta-Analysis. PLoS ONE 9(5): e95132. doi:10.1371/journal.pone.0095132 Editor: Cheryl S. Rosenfeld, University of Missouri, United States of America Received June 20, 2013; Accepted March 24, 2014; Published May 14, 2014 Copyright: 2014 Agha et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: These authors have no support or funding to report. Competing Interests: The authors have declared that no competing interests exist. * E-mail: mail@riazagha.com